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April 3, 2008

Not So Sound

I was approached by one of those 3D ultrasound places to come in for a little "look see" of the new babe. I admit that at first I was a little hesitant about it- would I want to promote something like an ultrasound for entertainment purposes? Surely if it could replace the medical ultrasound, I'd consider, but no- it's just for a family keepsake. And so, I'm just not so sure.

I started to dig around on the Internet about it, and I know that you can probably come up with anything to support your conspiracies online, but some things I am finding are making me think twice or thrice about it all.

You see, when I was pregnant with my first child, we had an ultrasound around 8 weeks to determine his due date. Then we had the standard 20 week one and during this one they couldn't get a good enough look at the kidneys, so they ordered another ultrasound. With each one they still weren't seeing what they wanted, scaring this first time Mom into the possibility that my baby would be born with only one or no kidneys and needing emergency surgery at birth. Seven ultrasounds in all, still no help... and when Noah was born, he was perfectly fine. Two healthy kidneys and all.

I know that if in fact he had had serious kidney issues, it would have been beneficial to know ahead of time. But I also am concerned at the amount of ultrasounds we ended up having - which at the time I never thought to question the safety of- and each time they still couldn't clearly see what was really wrong or right. For something so ineffective (in our case) how much is too much?

I'm 16 weeks along now with baby number four and we're due to schedule an ultrasound in a few weeks. The 3D ultrasound idea sparked my interest to be more educated on all the facts about how much research has really been done regarding the safety of ultrasounds- medical or "keepsake" versions.

I found out that in three separate studies, ultrasound exposure in boys has a strange effect of the child being born left-handed. (Noah's left-handed.) And this also points to higher instances of autism and epilepsy. (Read Noah's story here.) And learning delays as well. (Something we're working through right now.) It's about genetic alterations happening... and this just makes me want to know more.

And it makes me wish that more parents were aware. Maybe you are? It seems as though many expecting parents, if insurance paid for it, would have an ultrasound every month or day just to get a glimpse of what their baby looks like. Of course we wish we could know! Or, if they can't determine the sex on the first ultrasound, they'll try for another.

The 3D ultrasounds are super-tempting because they are even more realistic and those first images of the baby growing inside are magical. But do most parents consider that there might be risks involved with this type of exposure? Are there regulations on how many times a Mom can have one done? If someone had the money to get five or ten of them just because they wanted these keepsakes, would they be allowed? How would anyone be able to keep record of it anyway?

I'm seriously considering no ultrasound at all for this baby. It might finally settle the debate on whether or not we find out if we're having a girl or boy (I just might get my way now!)

But all kidding aside... I know there are very real and important reasons to have an ultrasound if necessary, but the definition of necessary is what I am questioning.

41 comments:

I am SO glad to see you talking about this. So many parents don't think twice about ultrasounds, we didn't either until we had our first (6 weeks along) and realized we had no clue how an ultrasound even worked. After researching we quickly decided we would never have another unless it was 100% neccesarry.

So many don't realize that 'standard' 20 week ultrasounds are not even recommended for the majority of pregnancies! And there are even more accurate ways of judging due date. That said, due to delivering 12 weeks early, I will have "routine" ultrasounds next pregnancy, if the problem is as suspected it is 100% neccesary if I'm to carry abany to term. So I do understand the benefits, but in most cases I don't think the benefits even come close to outweighing the risks and unknowns.

I've been dealing with a similar issue lately. With my first pregnancy I had a total of 4 ultrasounds. One at 6 weeks, 20 weeks, a selfish 3D ultrasound and a final one the day before my daugher was born in correlation with a stress test. With my current pregnancy (I'm 22 weeks along with another girl) my husband and I have decided not to do the 3D but signed up for the integrated test that detects Down's syndrome earlier in the pregnancy. When we first agreed to see the perinatologyst (spelling???) we were told the test included bloodwork, a 13 week ultrasound and the typical 20 week ultrasound. Every time we go back, the perinate's office schedules us for another ultrasound. When questioned why we are told they need to keep a close eye on the baby's growth and development. We have questioned if the baby seems like she is at risk for any problems and keep getting reassured that she is perfectly healthy. At my last visit the doctor told me he has never met anyone like me because most parents love to take every chance they can get to see their developing fetus. Like you the only reason I keep asking why is because we don't really now the affect of too many ultrasounds on the fetus or how many is too many.

I agree. I can be so confusing to figure out what is fact and what is speculation sometimes. Here they only do one unless they see something wrong, which they did with Bria. Then I had just one more to try and get a better look at about 36 weeks. I'm glad they did, because Bria has deformed Kidneys. But, I agree that I don't really think they are necessary, and they are potentially quite hazardous.

You're right to question the safety of ultrasound. I would strongly discourage anyone from using those "entertainment" ultrasound places because you have no way of knowing how much u/s exposure you're getting and whether the person doing the u/s has any knowledge at all. Even the FDA recommends against them.

That said, I think u/s does have a place when it is necessary. Routine u/s for no medical reason is just another intervention that may someday be shown to have harmful effects.

I planned to not have any u/s during my last pregnany (and this one) but ended up consenting when we discovered twins. And since twins sharing a chorion need closer monitoring, I ended up with several u/s-much more than I was/am comfortable with. It's all about risk vs. benefits.

While living in NYC I (which was not known to me at the time) picked randomly out an Oxford Health Handbook a high-risk OB/GYN practice. Mind you it was before I even was contemplating having a baby. This is way back in 2001.

2004. William was born. They issue standard practice there a 7 week. A 12 week. A 20 week. A 24 week. A 32 week. And a 38 week.

2005. Alexander. They issue the same standard sonograms.

Everyone, I mean everyone kept telling me (who went to practices that did not issue that many) that that was WAY TOO much and I was hurting the baby. A first time mom, a second time mom... I don't care if it's your 100th, you get nervous.

I did the research.

I called Brown University Medical Center. Spoke to Ob/Gyn people from Lenox Hill Hospital in NYC. And from Women & Infants Hospital in RI.

Everyone said the same thing... it's 100% safe for the baby.

I miscarried my next pregnancy at 7 weeks.

And then for Benjamin and this baby, they had me go every week until my 14th week for a sonogram. We're talking... a have a mini-portfolio! They issued one each week b/c they wanted to make sure the growth of the baby was exactly where it should be. With the baby I miscarried, we had seen a strong heartbeat at 6 weeks. A week later, nothing. It terrified me.

So I did more research. (Just what every doctor loves to hear).

And they told me I could (if I wanted to) continue to come every week if I wanted to... that it was not going to harm the baby at all.

Believe me, I know there is research out there to support any and every theory. I have never done a 3-D sonogram.

But I will say... I have heard all the theories and suggestions and research.

I have heard about the left-handed one.. WIlliam and Alex are both right.

And they both were talking and walking (rather freakily) early... William at 8 month, Alex at 9 months.

Benjamin at 10 1/2 months.

I wish I could tell you definitive info... sometimes I wish I had followed my original plan in going into the medical profession b/c it fascinates me.

I hope this helps Steph! And thanks for bringing this up... I think it's SO important.

And FIND OUT WHAT YOU ARE HAVING!!!! :) if they couldn't tell at 16 weeks... think GIRL. The boy part is usually like a flag waving for a 3D this far along.

Sometimes it's hard to even research this stuff anymore, because I honestly don't know that they have all the answers. Would a doc say it's fine because that's what he was taught, or has he actually *recently* researched it and come to that conclusion?

In the end you just pray about it and go with what you're feeling led to do. We can analyze till we're dreaming about researching, but in the end we trust we are in His hands.

This is so interesting...I feel like I've learned as much from the comments as the original post! I certainly had never heard of the studies you mentioned, but I do remember running across the odd article or two online when I was pregnant. I had a total of 3 ultrasounds, and did not know it was ever routine to do more than that! Like most things, it sounds that less is more when it comes to any medical interventions. Still, it is tempting to see that sweet little side profile!

Good thoughts, def! Good on you for checking things out for yourself instead of just going with the flow. I had 1 ultrasound for each of my 2 children. I have no concrete date to back up the hesitant feeling I have about multiple ultrasounds and the ones just "for kicks". It seems to me that more people get freaked out over these supposedly "helpful" ultrasounds for no reason in the end. Hang in there, trust the Father...He will def give you peace one way or the other!! Thanks for sharing...have a great day! :)

Well, my son is left handed (which I don't find odd, but I'm sure it had nothing to do with an ultrasound because we only had one, and lefties run in the family)! I have always assumed they were safe, and never considered otherwise. But that certainly doesn't mean they are. With my daughter we had several done because it was a very high-risk pregnancy. Thankfully, as of yet at least, they don't seem to have effected her.

But, if you have ANY concerns at all, then I say just skip them. I've learned that are many things they want to do, but they really can't require you to do them. In the end, the choice is yours (just like with vaccinations!) When I was pregnant with our daughter, I received a phone call telling me I was going to have a test to check her heart because our son had been born with a heart murmur. They said it had to be done to make sure she wasn't going to have one, because the pediatrician would need to know up front. I asked a couple of questions, including really, what advantage would it be to know ahead of time? And it was simply so the ped. would be aware. I said no - that they could check her when she's born and if she has one, they would know then. I thought it was nuts. I don't think he quite knew how to take that - that I had refused, but I didn't care. I also refused a vaccination in the hospital that I supposedly needed "just in case I was ever going to have another baby." Umm, NO. And that nurse wasn't sure how to take that either.My point, I guess is...do what you are comfortable with! I say if in doubt, don't do it! I mean, what are they going to do if you refuse? Probably look at you like you're crazy, but that's about it!

I've read all the ultrasound research. I hate that my instinct is to research everything, because I end up skeptical about everything. I think having one ultrasound is okay, and good actually. Just to make sure your placenta is where it should be, and there are no glaring problems that you'd need to know about at birth. I'd rather have a short diagnostic ultrasound than hemorrhage. I loved To Think is To Create's comment-- I TOTALLY agree with what she said. I had my big ultrasound today (we know the gender-- it's posted on my site!!!) but I was a little uncomfortable with how long it seemed to take. This was u/s number THREE for us. I didn't read anything about the safety until after the second one. Thankfully, unless something weird happens, we shouldn't need another.

I've looked into this and Adam and I both agree IF we have an ultrasound it will just be one at 20 weeks.

I know a woman who owns a 3D ultrasound company. They do elective ultrasounds, but their employees are trained sonographers--they also do ultrasounds for doctors offices, etc.

The way she explained it to me once is that the 3D is the same as a regular ultrasound, but they just use a different program to analyze the images and make it look 3D and it's not any extra or intense exposure.

Not sure if that's true or not--haven't had a chance to really look into it but just adding my .02.

I have 6 children and am expecting number 7 one week before you are due. We had ultrasounds with our first 5 and then we started doing more research and found there was no need for us to get one. We had a wonderful midwife who explained to us that they really don't know what harms that can be caused by ultrasounds but they also can't prove that there aren't side effects. It was a little nerve wrecking with number 6 not knowing if everything was o.k. but an ultrasound is not as accurate as they say. Which you found this out with your first one. So I say why get one when you don't know what side effects this could have with your unborn child.

By the way it is really fun being surprised after all that hard work of labor.

Great post Steph! The only reason we got one (at 20 wks) was to know the sex, but my midwife was actually trying to talk me out of it, telling me that we didn't need it UNLESS we really wanted to know the sex... and WE DID... so we had it, but I agree, for Wade and I, the risk, the unknown about ultrasounds, didn't seem worth it to me.

Thanks for bringing this topic to light. I have always wondered about what the risks are of too many ultrasounds. We only had the standard ones (at 8 weeks and 20 weeks) and one on the day of my due date to check if everything was okay. I could have had many more as my husband's aunt and uncle are both OB/GYN and they offered, but it just didn't seem right...

Great post. My personal conclusion is that I would use them if medically necessary, as the tool it was intended to be. I did have a few extra U/S at the end of my pregnancy due to gestational diabetes. But no, I would never get simply for entertainment purposes. Why mess with something that could have possible risks and at the least is annoying to the baby.

I am a fan of ultrasounds since I firmly believe Beatrix's life was saved by our ability to see what she was up to in there (it turns out she was up to no good and needed to come out PRONTO).

While I strongly suspect an ultrasound saved Beatrix, I know for a FACT it saved the lives of my identical twin nephews, who had Twin-To-Twin Transfusion syndrome---diagnosed by a fortuitous ultrasound at 18 weeks. My nephews are bright, friendly little guys approaching their third birthday in May. Some of the ultrasounds she had lasted for more than an HOUR, literally, because twice a week for the next 14 weeks she had to have fluid drained from Ben's bag of waters and fetal echocardiograms on both boys, as well as growth scans. They were born at 32 weeks.

BUT I can fully see and appreciate a woman's decision to skip ultrasounds in a singleton pregnancy with a young, healthy mom.

I totally appreciate the technology and won't hesitate to use it in the future, responsibly, though. No "vanity" ultrasounds just to get a picture for the fridge.

What a great post! I had two US with my little on and did not get any more. I could have had one to screen for Down's and I said No Way! The first one I had because I was so nervous I would miscarry again. The second was the standard 20 week. I think it is crazy that people are having those 3D and 4D US. I think parents should say pass on too many US!

ahhh....the ultrasound. I had one to determine how far along I was with Mason (at 8 weeks) THAT was all my insurance would cover. I had no idea the controversy or IF there was any complications that could arrise out of having them. I was only 19!~ BUT then I started to bleed and almost lost him. I immediately agreed to have another. THAT is when they gave me the 3-D. I could see him. NOT just like any other ultrasound but AS A BABY. I saw his nose SHAPE and the puffyness of his eyes and his wide jaws. I was in love. I'm glad I did get to find out. B?C with your first you always by tooo much and by this time EVERYONE and their g-mother told me I was "carrying" a GIRL. MAN were they shocked.

With Terri I only had two as well. One at 20 weeks (GIRL) and one at 36 weeks. I was SO LARGE that my OB was concerned that I wouldn't be able to deliver naturally.(my frame and a 10 lb baby didn't mix too well.) Instead of inducing me 2 weeks early CLINT wanted to do it naturally. ONE C-SECTION LATER we now know that I can't push out NO TEN POUND BABIES!!! ::insert bad grammar::

I don't agree with what TomKat did. I think that taking advantage of such things is very risky but I am not apposed to my dr."checking" to make sure that everything is OK for mom and baby.

SO Steph I would strongly advise you and your husband to pray about this and IF you feel the need to find out the babies sex, then do it. BUT DON'T if you feel so strongly against it. Ask God, he always seems to ease us of such burdens.

I only had one ultrasound w. each child. Both didn't have any questions in their development. In fact, both doctors said there is really no need to be doing ultrasound after ultrasound. I think you hit the nail on the head about that emotional feeling we get when we see the baby. For us it was all about finding out the sex, which is selfish. I admit it.

While science and technology is a good thing, we also have to be informed of the possible side effects that come along with it. It's so hard when you can gather so many pro and con views!

When you get right down to it, no matter how your child comes out, your love will be the same.

Well, and I think the first ultra sound to determine how far along you are isn't one that is needed.

I would probably still opt for one "normal" U/S further into the pregnancy just to have a look and make sure there aren't any major issues we'd need to know about...since we don't do any of the testing they offer.

But as far as a 3d for the fun of it, we've never had one and likely won't. And it is very interesting to know the facts about the possible damage a U/S can do...since my first born has learning disabilities.

It just all points to my belief that my son's problems are more than just vaccines...it's a plethora of issues and this might be one of them.

I'm also going to be looking up the possible negative effects of an epidural if I get pregnant again. They don't work right with me so they end up having to keep giving me more and more...I'm sure this isn't good for the baby ...

My doctors are going to love me (not) if I get pregnant again. I have a feeling I'd be better suited for a midwife than a traditional OBGYN.

Anyway, great post because it has gotten me thinking about this issue and what I'd do if I became pregnant again.

Whatever you decide you have my support! ;) Even if I'm personally dying to know the sex of your wee little one ;)

I had three ultrasounds in total, the "standard" 20 week one, another because I accidentally bumped my bump, and the third at 12 days over as part of my negotiations to go 14 days over.

The first, if I'm completely honest, I really wanted to see my little bean to know she was real! The second, I was glad to get as I got an awful fright when I bumped my bump. And the third, well I didn't want another one really, but the doc was quite insistent on it to check the fluid levels and placenta if I wanted to go 14 days over so we agreed.

Funnily enough, if you can afford to go private in Ireland you get a lot of scans, one at every visit. So unnecessary and one gets the impression that it's the consultants trying to justify their huge fees!

Many doctors here caution against "recreational scanning" which I think is a great description of 3d scans!

Well, I would be the kind of person to have one in my own home if I could. ; ) I think they are so cool and patience isn't one of my strengths. It is good to be informed. Remember, that little one's angels have charge over him/her and NOTHING shall BY ANY MEANS harm him/her!

Ultrasounds were LITERALLY lifesavers in the case of all three of my pregnancies - if we had not had them, my children would have died. ALL THREE TIMES.But it is VERY important to remember that it is against the law for anyone who is not a medical personel to administer an ultrasound, and with good reason.There are LOTS of insane claims out there for many things these days - I always check www.quackwatch.com first.

No opinions to share (I loved my 12 week ultrasound--made my pregnancy seem so much more real), but I had a very strange dream the other night that I had a 3D ultrasound and it showed the baby had a cleft lip/palate. Weird dream. In any case, I don't plan on having more than 2 ultrasounds, but it did make me think a little about the power of modern ultrasounds, for better or for worse.

I personally have no thoughts on whether it can hurt the baby or not. My oldest had sonograms once a month up until 7 months and then once every other week until delivery. There is nothing wrong with her, but I had complications so they had to check her out. I had a 3D at the dr's office with my oldest, but did not and would not with my youngest. I didn't bond with my oldest and I think it was because I fell in love with that picture. It was like we had all ready met so the magic was taken out of it for me. Who knows, but there's my 2 cents!

I don't know if it is true or not, but I always heard that too many ultrasounds can cause ear problems. The baby can be more prone to ear infections. Like I said, I don't know if it is true or not. However, if you do go for the 3D ultrasound, wait until around 25 weeks. The baby will look cuter because it has started putting on body fat.

The 3D ultrasound is the same as the regular ultrasound, they just convert the pixels (squares) into moxels (cubes) to get the 3D image. (We learned this from our ultrasound tech). We decided to forgo the early ultrasound and only do one at 18 weeks. I've read arguments that go both ways. Some say that since it isn't radiation, it's sounds waves, that there's no harmful effects. I'm not sure what I think about that but I'd rather not take the chance.

I think having 1 around the midpoint of the pregnancy is beneficial because usually by then the baby is big enough to see everything. They can give you information so you can be prepared if there is something wrong.

While I was pregnant with my son, now 9 months old, I had lots of u/s. Because I was high risk (on blood thinners), I had at least 2 more than the usual during the first two trimesters and at least one every week for the last 6 weeks. They had to closely monitor his growth and also my placenta's health. As of now, he is a perfectly healthy boy.

I have mixed feelings about the benefits. Before my son, I had 3 first trimester miscarriages. All 3 were only discovered through ultrasound. So, I actually cringed every time I had one. I kind of felt that the u/s room was where you found out about miscarriages. However, when we did get to see our son healthy and moving in there, my stress level would drop significantly.

As far as left-handedness... I would be thrilled if my son was a lefty since I'm one (with no u/s as a fetus). I theorize that the somewhat recent increase in left handedness has less to do with any prenatal differences as it does with the population being more accepting of lefties. My mother firmly believes that my younger bro would have been a lefty except my very old-school grandma kept forcing him to switch hands when he'd do anything left handed (not an uncommon practice among her generation).

I do often wonder how many of the "necessary" procedures are really necessary. Plus, after watching "The Business of Being Born", I really have to wonder.

I wish that IF I have another baby, I could have a more natural experience. However, with my high risk status, I may not have as much of a choice.

Please keep us up to date on what you learn. And, thank you for beginning this discussion.

I had no ultrasounds with either of my babies. It wasn't considered mandatory then. My babes are 16 and 21, the 16-yr-old has disabilities, but they would not have shown up on an ultrasound. You are wise to question this and do your research.

I look at ultrasounds as insurance--if you never need it, it seems like a waste. When you do need it, you're so glad you have it. The hard reality is, even with all the research in the world, we can't know everything.

Regardless, I don't think "medicine" belongs in the same sentence as "curiousity" or "recreation."

I've never been interested in doing the 3D ultrasound, and like said here - medicine and recreation should not be mixed. And Tom & Kate - that's just horrible.

I've had three kids in three different countries, and the most ultrasounds were done in Germany. Interestingly, the most natural way to approach child birth was also in Germany. They use only natural ways to enduce labor, and in my case the only "pain relief" used was aromatherapeuthic scents and the calming water in a bathtub.

I have read information both against and for ultrasounds, and I think the key is moderation. I would never have an ultrasound just for fun, or just to get a picture of my baby, but to ease my mind the baby is ok. I have never found out the sex of the baby either.

I was happy I had so many ultrasounds with my daughter in Germany, I wanted to have a waterbirth, but her shoulders were 3 centimeters wider than head circumstance, and it took over two hours to push her out and even then she was all blue. I was very thankful that the wide shoulders were noticed in ultrasound and the waterbirth was not recommended by my midwife. She is right handed, and one of the sharpest kids in her class, and has had no medical issues at all in her 6 years.

Great Topic! With my 1st pregnancy, my Dr. did an ultrasound EVERY visit. I thought that was normal...b.c I didn't know any better. My daughter turned out perfectly and right handed too. he..he.. But, this topic is very valid and worth more research. Good Luck to you in your decision!

Have you ever attended the CHOICES Group in your area? My SIL who lives there went last week and Loved it!

I'm enjoying your blog (found through Chicago Mom Blog). As a pediatrician I can't see how ultrasound would be harmful to the baby, and definitely don't see how it could make the baby left handed! But as a mom (trying for a second now :)), I can understand the apprehension. With my first pregnancy ("high risk" because I have scleroderma) I had more ultrasounds that I want to remember. I wonder if the mother's stress caused by all the testing that the ob/gyns want to do can harm the baby in some way...

I think it's very interesting to see all that you have researched. I am 22 weeks, and have had the regular 12 week and 20 week sonos. I have never heard of sonograms being bad for the baby, but I always thought of them as a window to help the mom prepare for girl/boy, as well as if there are health issues.

With my DD, I was exposed to 5th's disease, which could have caused a lot of problems, and it scared me. The two of us were monitered by sonos for about 10 weeks, and I shed a sigh of relief each time they told me my baby was doing well. I was nervous about all the sonos, but grateful that we could be sure all was well.

My sister did not have a sono with her 3rd child. That child was born with a VERY serious heart condition, that would ahve been spotted at the sono. My sister regrets it each day, since they could have been more prepared.

I also think sonos are important to see how many babies you have. My cousin's wife didn't know she was having twins until 6 months along, because her midwife did not recommend a sono until she was much larger than usual.

I think that you should do at least one, and find out if there is pink or blue in your future, and all is well with your baby, and not the 3d.

Funny, I never questioned the ultrasounds, but probably because I had a midwife and they only prescribe you one if you really need it. For my first I had quite a few at the beginning as we thought I was miscarrying but it was a twin that I miscarried. Then I only had one at 20weeks and that was it. With my second I had one at 8 weeks, 20 weeks and 39 weeks. That was it. And we only had the last one for measurements as I was having her at home we had to see how big she was. She was a 9.5 pounder but there was no trouble.